Free tissue transfer versus pedicled flap reconstruction of head and neck malignancy defects

Abstract

Pectoralis major myocutaneous flap remains an enduring and safe flap; however, the RFFF has markedly improved speech performance over the PMMF.

Microsurgical Reconstruction of the Oral Cavity and Oropharynx After Cancer Ablation

“…When is the focus is shifted to speech, a direct comparison of the RFFF and the pectoralis major pedicled flap show a distinctive advantage of the free flap. Also, intraoral dehiscence rate for the pectoralis major flap was significantly higher than that of the RFFF (O'Neill et al, 2010). …”

Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation

“…Aesthetic evaluation was subjective, being performed by patients themselves using a visual analogue cosmesis score (0e100) (Chang et al, 2009;O'Neill et al, 2010).The cosmetic evaluation was assessed as follows:100e75, no deformity; 75e50, minimal deformity; 50e25, moderate deformity; and 25e0, severe deformity.…”

Salvage for pectoralis major myocutaneous flap failure in head and neck reconstruction by microvascular flap

“…The pectoralis major myocutaneous pedicled flap (PMMPF) is considered the "workhorse" flap for head and neck reconstruction operations after its introduction in 1979 by Ariyan [1][2][3][4]. Despite advancements in microsurgery, this flap continues to be the primary reconstructive choice for several reasons, such as good coverage, readily identifiable and reliable bloody supply, reduced operative time, simple technical aspects, lower patient comorbidity, and proximity to the head and neck region [3,[5][6][7][8].…”

“…However, the disadvantages of the PMMPF include cosmetic deformity, flap bulkiness, lack of arc rotation, morbidity associated with donor and recipient sites, and a high incidence of complications [2,9,10]. The high incidence of complications is associated with smoking, diabetes, previous radiotherapy, obesity, and an inexperienced surgeon; it can be further increased by infection and wound dehiscence [2,6,11].…”

“…The high incidence of complications is associated with smoking, diabetes, previous radiotherapy, obesity, and an inexperienced surgeon; it can be further increased by infection and wound dehiscence [2,6,11]. In these situations, a secondary operation is required, with the incidence of such secondary operations ranging from 10%-50% [11][12][13][14].…”